title: Therapy of ulcerated hemangiomas.
abstract: BACKGROUND
  Cutaneous ulceration is the most common complication of infantile hemangiomas (IHs) seen in a pediatric dermatology practice.
  
  
  OBJECTIVE
  The most effective treatments in our experience are compared to those in the current literature.
  
  
  METHODS
  The study was a retrospective chart review of therapy of 169 ulcerated IHs at a tertiary care pediatric hospital and a literature review.
  
  
  RESULTS
  Combination therapy was the rule. Local wound care was required in all, pain management in 72%, pulsed dye laser in 42%, infection control in 38%, diminution of the hemangioma through systemic therapy in 36%, and suppression of bleeding in 2%.
  
  
  CONCLUSIONS
  A retrospective review compared to a case-control study has inherent bias. In addition, our cases were all at a tertiary referral center.
  
  
  CONCLUSIONS
  All ulcerated IHs benefit from local barrier creams or dressings. Pulsed dye laser, antibiotics, topical morphine 0.1% in hydrogel, topical becaplermin, and, most importantly, systemic therapy (especially propranolol) to reduce the hemangioma may be useful.
authors.affiliation: Department of Family Medicine, McGill University, Canada. catherine_mccuaig@sss.gouv.qc.ca
authors.forename: Catherine C
authors.initials: CC
authors.lastname: McCuaig
authors.forename: Lynn
authors.initials: L
authors.lastname: Cohen
authors.forename: Julie
authors.initials: J
authors.lastname: Powell
authors.forename: Afshin
authors.initials: A
authors.lastname: Hatami
authors.forename: Danielle
authors.initials: D
authors.lastname: Marcoux
authors.forename: Catherine
authors.initials: C
authors.lastname: Maari
authors.forename: Louise
authors.initials: L
authors.lastname: Caouette-Laberge
authors.forename: Patricia
authors.initials: P
authors.lastname: Bortoluzzi
authors.forename: Sandra
authors.initials: S
authors.lastname: Ondrejchak
authors.forename: Josée
authors.initials: J
authors.lastname: Dubois
mesh_terms: D006391:Hemangioma / Q000150:complications / Q000628:therapy*; D006801:Humans; D012878:Skin Neoplasms / Q000150:complications / Q000628:therapy*; D012883:Skin Ulcer / Q000209:etiology / Q000628:therapy*